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Fatigue during and after cardiac rehabilitation
Myrna Elena van Geffen1, Nienke Ter Hoeve, Madoka Sunamura
1Department of Rehabilitation Medicine, Erasmus Medical Centre, CAPRI cardiac rehabilitation, 3016BC Rotterdam, The Netherlands. m.vangeffen@caprihr.nl.
Objective:
To estimate fatigue during and after a multidisciplinary cardiac rehabilitation programme and its association with aerobic capacity.
Design:
Longitudinal cohort study.
Patients:
A total of 121 patients with coronary artery disease (79% men), mean age 57 years.
Methods:
Fatigue was measured with the Fatigue Severity Scale (FSS) and aerobic capacity with the 6-min walk test (6MWT). FSS scores ≥ 4 were defined as fatigue and >5.1 as severe fatigue. Measurements were taken before (T0) and after rehabilitation (T1) and at 1-year follow-up (T2).
Results:
Fatigue decreased from 3.49 at baseline to 3.03 post-rehabilitation (p=0.002) and decreased further to 2.75 at follow-up (p<0.001 vs T0). At baseline, 17.7% of patients were classified as severely fatigued. After cardiac rehabilitation, the prevalence decreased to 10.6% (p<0.001) and to 8.1% at follow-up (p=0.011 vs T0). Although the prevalence of severely fatigued patients decreased, it was still high compared with healthy individuals (3.5%). Aerobic capacity was weakly associated with a reduction in fatigue (p=0.030).
Conclusion:
Fatigue decreased during and after cardiac rehabilitation. However, the prevalence of severely fatigued patients remained high after cardiac rehabilitation. Fatigue should be identified at an early stage in order to provide additional programmes aiming to reduce severe fatigue.
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